american immunization registry association annual … · quan le, louisiana non-voting directors...
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REPORTOCTOBER 1, 2016 – SEPTEMBER 30, 2017
ANNUALA M E R I C A N I M M U N I Z AT I O N R E G I S T RY A S S O C I AT I O N
AIRA BOARDOfficers/Executive Committee Mary Woinarowicz, North Dakota – Immediate Past President Michelle Hood, Nebraska – PresidentKim Salisbury-Keith, Rhode Island – President ElectBelinda Baker, Washington – Treasurer Jenne McKibben, Oregon – Secretary Baskar Krishnamoorthy, Florida – Member-at-Large
Voting DirectorsBridget Ahrens, VermontBrittany Ersery, KansasDavid McCormick, IndianaMegan Meldrum, New York State Quan Le, Louisiana
Non-Voting Directors Brandy Altstadter Scientific Technologies CorporationKevin Dombkowski University of Michigan
AIRA STAFFRebecca Coyle, Executive Director Alison Chi, Program DirectorMary Beth Kurilo, Policy and Planning DirectorCarmela Gupta, Senior Program Manager Maureen Neary, Senior Project ManagerNathan Bunker, Senior Technical Project ManagerNichole Lambrecht, Senior Project ManagerEric Larson, Senior Technical Project ManagerAmanda Dayton, Business and Grants ManagerKetti Turcato, Program ManagerAmanda Branham, Membership and Executive AdministratorBrittany Gyer, Administrative Assistant
WELCOME | AIRA 2017 Annual Report
Hello AIRA Community,
I am pleased to share with you AIRA’s first Annual Report. Our intention with this report is to showcase AIRA’s progression toward meeting its goals as described in the 2017-2019 Strategic Plan.
The first section of the report describes the structure of both the organization and AIRA’s membership program. This is followed by an overview of the existing landscape of the
greater immunization information system (IIS) community and the specific ways in which AIRA is striving to improve IIS operations and serve as a leading authority on IIS. Additional sections identify educational offerings, meetings and resources developed by AIRA over the past year, various initiatives under way to support IIS, such as the Measurement and Improvement Initiative, technical assistance, and the development of services that can be shared across the community. This report concludes with an overview of AIRA’s fiscal position and a thank you - to all of those who work tirelessly to make the IIS community stronger.
To say it was a busy year seems like such an understatement! We sincerely hope you enjoy learning about AIRA and the IIS community.
Sincerely,Rebecca Coyle
Vision, Mission, and Purpose of AIRAAIRA Vision: To facilitate the sharing and use of immunization information by all partners and ensure that immunization information systems are fully supported and represented.
AIRA Mission: To promote and support the use of immunization information to ensure healthy communities.
Purpose: The purpose of AIRA is to support and promote the development, implementation, and interoperability of immunization information systems through partnerships, peer and professional education/training, and resource development.
General Inquiries: [email protected]
Address: American Immunization Registry Association 1155 F Street NW, Suite 1050 • Washington, DC 20004
Phone: 202.552.0208
2
WELCOME
Supporting the mission and vision of AIRA through a strong organizational structure
STRUCTURE
AIRA is more than just its dedicated staff and board members. Many of AIRA’s initiatives are created and carried out by members who participate on AIRA steering committees and workgroups. AIRA also employs the services of consultants with expertise in technical writing, facilitation, and project management to ensure the success of its guidance documents and initiatives. This combination of staffing, volunteers, and consultants enables AIRA to support the needs of the organization and the IIS community.
AIRA STEERING COMMITTEES Assessment Steering Committee (ASC) co-chaired by Deborah Richards and Heather Roth
Education Steering Committee (ESC) co-chaired by Jenne McKibben and Katie Reed
Modeling Immunization Registry Operations Workgroup (MIROW) co-chaired by Warren Williams, Elaine Lowery, and Mandy Harris
Standards and Interoperability Steering Committee (SISC) co-chaired by Mary Woinarowicz and Craig Newman
AIRA WORKGROUPS Measurement for Assessment and Certification Advisory Workgroup (MACAW) co-chaired by Aaron Bieringer and Jane Lammers
Joint Development & Implementation Advisory Workgroup (JDI) co-chaired by Bill Brand and Michael Flynn
MEMBERSHIP
AIRASTAFF
AIRACONSULTANTS
AIRABOARD
AIRAWORKGROUPS
AIRACOMMITTEES
3AIRA 2017 Annual Report | STRUCTURE
IIS COMMUNITY Promoting membership engagement
“…it was very helpful knowing that AIRA is always on top of doing everything they can to help the community and their members… even non-members. AIRA always has great subjects and topics of discussion shared via various methods—webinars, meetings, newsletters, email, etc.”
— Celena Calvo-Story, AIRA 2017 Education Survey
AIRA offers membership to immunization information systems, IIS implementers, and not-for-profit organizations that share and support its mission. AIRA’s Partnership Program offers an opportunity for individuals and entities who support AIRA to work together to address health issues affecting the nation.
IIS
AIRA membership provides opportunities for:Building and maintaining strong partnerships with other organizations to resolve common issues together
Advocacy for funding of IIS development and enhancement through legislation, policy development, and public information
Contributions to the ongoing development and evolution of IIS through knowledge-sharing opportunities and capacity-building activities
Advocacy for—as well as development, dissemination, and promotion of—IIS standards
In 2016-2017, there were 485 AIRA members representing:
7 non profit
organizations
6 for-profit
organizations
57 IIS
jurisdictions
11 individuals
7 IIS
implementers
4 IIS COMMUNITY | AIRA 2017 Annual Report
Overcoming challenges to sustain IIS
FUTURE OF IIS
IIS are important tools in the public health system and exist to improve and protect the nation’s health from vaccine-preventable diseases. Yet, despite their importance and necessity, IIS face persistent challenges, including:
IIS provide an essential public health service and are an important part of the nation’s public health infrastructure. Yet these persistent problems facing IIS threaten to cripple their very existence.
Through its resources and initiatives, AIRA seeks to reduce variability among IIS, promote shared knowledge, and increase the efficiency of IIS operations. It also seeks to overcome the challenges described above through:
Collaboration Uniting IIS in the development of standards and best practices
Measurement and Improvement Assessing gaps in IIS adherence to standards and providing technical assistance to help IIS programs improve
There are many opportunities for AIRA members to get involved: Join a committee or workgroup • Volunteer as a subject matter expert • Write an article for SnapShots
Present at the annual meeting • Attend an educational webinar • Participate in the measurement and improvement initiative.
JOIN AIRA AND GET INVOLVED
Competing Priorities
IIS are managed by jurisdictions, each with their own priorities.
Standardization Implementing
standards is a slow and resource -
intensive effort.
Funding There is a lack of dedicated
and sustainable funding for IIS.Policy Limitations
State laws may restrict data exchange, require
signed consent, or prohibit data capture
for certain ages.
Technology Innovations
and modifications are not easily
shared.
Support Providing ongoing education, technical assistance, and advocacy
Shared Services Identifying services that can benefit all IIS for one price
5AIRA 2017 Annual Report | FUTURE OF IIS
JPHIT AIRA is a member
organization of this coalition dedicated
to promoting public health informatics.
NAIISAIRA presented to
NAIIS on the growing role of IIS and adult
immunizations.
ASTHOAIRA co-facilitates a
community of practice with ASTHO to increase
jurisdiction-to-jurisdiction data exchange.
AAP partnered with AIRA to identify
non-technical barriers and strategies for increasing provider participation in
Kentucky's IIS (KYIR).
HIMSSAIRA collaborated with
partners to demonstrate vaccine submission and query between IIS and
EHRs in real time.
ACIPAIRA was approved as a
liaison organization and will serve as a subject matter
expert on IIS.
HL7 WORKGROUPS AIRA participates in a variety
of working group meetings for Health Level Seven expert
volunteers.
NVAC AIRA serves as a liaison member and provides information and serves
as a subject matter expert on the value of IIS.
HPV ROUNDTABLE AIRA is a collaborating organization with this
consortium and represents the role of IIS in increasing
HPV vaccination rates.
Representing IIS interests and influencing national priorities
“Thank you for your role in supporting IIS!”— Leanne Bailey, Vaccine
Policy & Government Relations (Merck)
AIRA strives to represent IIS interests and serve as the voice of the community through attendance and participation at stakeholder meetings across the country. AIRA staff and volunteers attended countless meetings with over 45 unique partners in 2017. Some of the key stakeholder meetings AIRA attended are presented below.
To best represent the IIS community, AIRA regularly solicits feedback on key issues through the following process:
AIRA hosted more than
70 WORKGROUP MEETINGS
over the course of the year
IIS CHAMPION
ADD TO AIRA REPOSITORY and distribute to external partners
FINALIZEMONITOR trends/ identify issues
ENGAGE membership by requesting feedback
DRAFT response COLLECT
feedback
SHARE response with community
6 IIS CHAMPION | AIRA 2017 Annual Report
“The regional meeting was such a great opportunity to discuss current hot topics with others in a smaller, more intimate setting.”— anonymous from the
Oklahoma City Regional Meeting Evaluation
Regional Workshop
held in Southeast
region
10.18.16 12.19.16 1.9.17 2.27.17 3.13.17 3.22.17
10.24.16 12.19.16 1.23.17 3.1.17 3.14.17 4.24.17
SnapShotspublished
DiscoverySessionWebinar
DiscoverySessionWebinar
DiscoverySessionWebinar
SnapShotspublished
DiscoverySessionWebinar
ESCWebinar
DiscoverySessionWebinar
Regional Workshop
held in Centralregion
ESCWebinar
DiscoverySessionWebinar
DiscoverySessionWebinar
5.22.17
6.22.17 6.26.17 8.28.17
ESCWebinar
SnapShotspublished
6.22.17
DiscoverySessionWebinar
7.24.17
DiscoverySessionWebinar
SnapShotspublished
8.29.17
ESCWebinar
9.25.17
DiscoverySessionWebinar
4
2
4
4
10
AIRA serves as the leading authority in education and training for the IIS community. Over the past year, AIRA provided the following educational and training opportunities:
TOTALATTENDANCE
960
at Discovery Sessions and ESC webinars over the past year
Supporting increases in IIS competencies through training and education
EDUCATION
10 Discovery Session webinars were held for those new to the IIS community.
4 Webinars were hosted by the Education Steering Committee.
4 Webinars were offered to introduce a New Educational Tool or Resource.
4 Issues of SnapShots were published, highlighting the progress, best practices, and accomplishments of IIS across the country.
2 In-Person Regional Workshops were held, one in the Southeast and one in the Central region.
7AIRA 2017 Annual Report | EDUCATION
Advancing IIS Together
AIRA NATIONAL MEETING
8 AIRA NATIONAL MEETING | AIRA 2017 Annual Report
“Great conference. Really good mix of breakouts, plenaries, and roundtables. Also, ample time for networking which can be key to learning.”— anonymous attendee, AIRA
2017 National Meeting Evaluation
AIRA’s fifth annual national meeting was a huge success and featured: Keynote presentations from Dr. Nancy Messonnier, the director of the
National Center for Immunization and Respiratory Diseases (NCIRD), and Dr. Zubin Damania (ZDogg MD)
30 breakout sessions and 71 unique presentations on a variety of topics 3 small-group roundtables that focused on targeted topics Regional breakout session, where attendees were provided a networking
opportunity within their geographic region A live AIRA gameshow that highlighted AIRA’s recent products and activities
Saint Paul Minnesota
255attendees
2012
Denver Colorado
279attendees
2013
New Orleans Louisiana
338attendees
2015
Seattle Washington
350attendees
2016
Chicago Illinois
400attendees
2017
Previous Meetings and Locations2017 AIRA Award Winners
The AIRA 2017 National Meeting would not have been possible without the generous contributions of its meeting sponsors. AIRA thanks each
of its sponsors who helped make this year’s meeting a success.
CENTERS OF EXCELLENCE: Innovative Approaches to Increasing or Demonstrating Value of IIS
1ST PLACE: Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE)
LIFETIME ACHIEVEMENT
AWARD
Amy Metroka
Rob Savage
VOLUNTEER SERVICE AWARD RECIPIENTS
Aaron Bieringer
Michael Flynn
Therese Hoyle
Kevin Snow
Providing resources for optimal IIS performance
IIS RESOURCES
AIRA employs the following process when developing best-practice or educational guidance documents:
Introduction webinar held
Product finalized
AIRA project resources identified
Product developed
AIRA developed a variety of guides during the 2016-17 fiscal year to support IIS readiness and performance, including: “The quality and
quantity of guidance and educational materials over the 7 years I have been in this role has improved significantly—which we have used to improve our IIS. Thank you.” — Nancy McConnell, AIRA
Education Survey
Product released
Community review
Need for guidance identified
AIRA member and partner engagement
STEP 1 STEP 3 STEP 5 STEP 7
STEP 2 STEP 4 STEP 6 STEP 8
Confidentiality and Privacy Considerations for Immunization Information Systems
September 2016
DATA VALIDATION GUIDE
immregistries.org
For the IIS Onboarding Process
October 16, 2016
Confidentiality and Privacy Considerations for IIS summarizes different IIS confidentiality/privacy issues and provides considerations and sample forms.
327 11
Data Validation Guide for the IIS Onboarding Process focuses on the data validation process within the onboarding process.
February 16, 2017
545 10 Number of people involved in development
Hours to develop
Release Date
9AIRA 2017 Annual Report | IIS RESOURCES
March 15, 2017
Practical Examples of IIS Population-Based Coverage Assessments describes real-life examples of coverage assessments using IIS data.
273 24
PRACTICAL EXAMPLES OF IIS POPULATION-BASED COVERAGE ASSESSMENTS
March 2017
An Addendum to the Analytic Guide for Assessing Vaccination Coverage Using an IIS
immregistries.org
July 7, 2017
Security Guidance: Considerations for IIS explores the various issues that impact IIS security and provides guidance on addressing common security concerns.
541 21
Security Guidance Considerations for Immunization Information Systems
June 2017
August 25, 2017
Comparing & Communicating Vaccination Coverage Estimates offers tips and tools that can be used to help explain vaccination coverage assessment results to decision makers.
565 21
JUNE 2017
immregistries.org
COMPARING & COMMUNICATINGVACCINATION COVERAGE ESTIMATESFrom Immunization Information Systems, the National Immunization Survey, and Related Assessments
June 15, 2017
Implementation Guidance for a Shared Address Cleansing and Geocoding Service offers practical steps for integrating SmartyStreets into IIS operational and technical activities.
196 12
Immunization Information System (IIS) Implementation Guidance for a
Shared Address Cleansing and Geocoding Service
May 2017
September 26, 2017
IIS Data Quality Practices – Monitoring and Evaluating Data Submissions focuses on the ongoing data monitoring and evaluation process for incoming data submissions.
450 17
IIS DATA QUALITY PRACTICES
immregistries.org
Monitoring and Evaluating Data Submissions
IIS RESOURCES
Number of people involved in developmentHours to developRelease Date
“As a first-time participant, I enjoyed learning more about AIRA and the work being done. I am excited at the opportunity to participate more in the community and with AIRA.”
— anonymous attendee, AIRA 2017 National Meeting Evaluation
10 IIS RESOURCES | AIRA 2017 Annual Report
Assisting IIS in achieving standards alignment
ALIGNMENT
“Participating in IIS assessment has given us a lot of really great information on how our system stacks up against national standards. While we have some work to do, it is nice to have a no cost, very thorough, testing of our application done to help identify some of the changes we need to make.”
— Aaron Bieringer, MIIC Interoperability and Technical Lead
In 2015, AIRA launched the Measurement and Improvement Initiative to assess and increase the level of alignment between IIS and the community’s interoperability standards. This initiative follows a three-step process for IIS to measure their alignment with current standards:
1 Testing and Discovery – gathers preliminary information on community alignment with standards
2 IIS Assessment – involves more formal testing to measure individual IIS systems using IIS community-selected measures and tests
3 Validation – the summary stage to acknowledge and share results for IIS that are progressing toward or achieving alignment with community-selected measures and tests
This process is overseen by the Measurement for Assessment and Certification Advisory Workgroup (MACAW). MACAW recommends processes and measures to the AIRA board for review and approval once they have been vetted and accepted by the IIS community.
AIRA has completed the testing and discovery and IIS assessment phases for three specific areas of IIS functionality:
1 Message Transport
2 HL7 Submission and Acknowledgement
3 HL7 Query and Response
A summary of the highlights and progress of the IIS community for each measurement area follows.
Testing and Discovery
Assessment
Validation
Validated
11AIRA 2017 Annual Report | ALIGNMENT
MEASUREMENT AREA HIGHLIGHTS
AIRA continues to re-measure each of these areas every quarter and is developing test cases to measure IIS clinical decision support capabilities.
Since the initial baseline measurement, the following progress has been seen in each measurement area:
42% increase in the number of IIS nearing alignment (meeting two of the three tests)
71% increase in IIS known to have a Centers for Disease Control and Prevention web services definition language (CDC WSDL) implementation
200% increase in the number of IIS aligning with CDC WSDL specification
42% increase in the number of IIS able to accept the minimally required messages
400% increase in IIS passing the acknowlegement (ACK) measure
40% increase in the number of IIS meeting the timeliness measure of returning 95% of queries within five seconds
47% increase in the number of IIS passing the core data elements measure
250%increase in the number of IIS successfully passing the measure for returning a conformant response when no patients are found in the IIS
HL7 Query and Response
HL7 Submission and Acknowledgement
Message Transport
ALIGNMENT
12 ALIGNMENT | AIRA 2017 Annual Report
Providing technical assistance and support to IIS
ASSISTANCE
In January 2016, AIRA started a formal process by which its members could request technical assistance (TA). Last year, AIRA received 154 TA requests. AIRA publishes its TA responses in a “Frequently Asked Questions” format on the AIRA website.
AIRA staff or consultants visited the following locations to provide in-depth technical assistance:
CALIFORNIA
December 2016 To review and provide input
on California's transition from a series of regional IIS
to a state wide system
March 2017To review and provide
input on their transition from a legacy IIS to a
new state wide system
TEXAS
June 2017To assist in
operationalizing their HL7 query
functions
OKLAHOMA
IDAHO
August 2017To review IRIS
reports and assist in connecting to
AART
September 2017To provide HL7
training through peer-to-peer
assistance
GUAM
Likeliness to request TA again
Satisfaction with quality and completeness of response
September 2017To facilitate needs
assessment with the Spanish Ministry of Health to identify
key system functionalities
SPAIN
Topic of TA request
42%
12%
12%
10%
9%
8%
6%
Transport
Standards, Specifications, Codesets (CDSi, etc.)
Other
AART and Measurement
Software Products (DQA, SMM, etc.)
HL7 Format, Messaging, IG
Policy (MU, HIPAA, etc.)
32 unique IIS jurisdictions, 21 unique partners, and 2 unique
territories received assistance
“Without the assistance and support we have received through AIRA, we could not do what we are doing now in the same effective and efficient manner.”
— anonymous IIS manager/director–Information or Technical Assistance Request Evaluation, 2017
• 92% Very satisfied
• 5% Somewhat satisfied
• 3% Neutral
• 95% Very likely
• 2.5% Somewhat likely
• 2.5% Neutral
13AIRA 2017 Annual Report | ASSISTANCE
AIRA experienced a 16% INCREASE
in TA requests from 2016 to 2017.
SHARED SERVICES
AIRA supports the coordination, facilitation, and development of collaborative tools, applications, and technologies that can be implemented in multiple IIS programs. The following timeline highlights the accomplishments of this initiative.
Supporting cost-effective initiatives and joint development
Jointly developed projects increase efficiency,
improve data quality, and bring value
to IIS.
“The way we incorporated SmartyStreets into our workflow was quick and easy.”
— Pilot Summary, Address Cleansing and Geocoding Services
Since community launch, 11 jurisdictions have taken
advantage of this service to standardize, validate, and geocode their data.
March 2017
Findings from SmartyStreets pilot published
July 2015
Joint Development & Implementation
Advisory Workgroup convened
June 2017
Implementation Guidance published
September 2016
SmartyStreets selected as service
vendor
The pilot successfully demonstrated that the standardization, validation, and geocoding processes available through SmartyStreets improved the accuracy and completeness of incoming and existing data, as well as improved core IIS processes such as deduplication.
Following SmartyStreets standardization, pilot participants saw an increase in the deliverability of their reminder/recall messages from 71% to 88%.
Pilot Findings
June 2017
Access to SmartyStreets made available
to all AIRA member IIS programs
November 2015
JDI in-person meeting, address
cleansing identified as initial project
focus
September 2016–
February 2017
SmartyStreets piloted
with six IIS jurisdictions
August 2017
SmartyStreets user groups
launched
14 SUSTAINABLE IIS | AIRA 2017 Annual Report
15
FINANCES Demonstrating sound fiscal management
AIRA 2017 Annual Report | FINANCES
The financial information provided below summarizes AIRA’s financial position as of September 30, 2017.
2017 Overview
2017 Income by Type 2017 Expenditures by Function
$586,567 $242,725 $343,842 $92,882 $586,417
TOTAL ASSETS
TOTAL LIABILITIES
TOTAL UNRESTRICTED
NET ASSETSTOTAL
CHANGE IN NET ASSETS
CASH & CASH EQUIVALENTS
YEAR-END
• 88% Cooperative Agreements/Federal Funding
• 9% National Meeting
• 2% Membership Dues
• 1% Other
• 96% Program Service
• 4% Administration
Working together to make the IIS community stronger
THANKS
16 THANKS | AIRA 2017 Annual Report
Thank You to Volunteers!AIRA is a membership-based organization that values the voluntary and collaborative interaction of all its members.
AIRA would like to sincerely thank those who volunteered to develop products, submitted articles for SnapShots, presented on a webinar, contributed to the AIRA 2017 National Meeting planning, and participated on a workgroup or steering committee. Without their time, input, and effort, AIRA would be unable to achieve its mission and vision. AIRA largely credits its success to the collaboration of its members.
The map above illustrates the AIRA members who contributed (in green) to one of these initiatives over the past year and indicates committee and workgroup members who attended at least 50% of monthly meetings in the past year.
OK
GA
VA
NY
FL
NM
TX
KS
NE
SD
NDMT
WY
COUT
ID
AZ
NV
WA
CA
OR
KY
ME
PAMI
MA
CT
WV
OHIN
IL
NCTN
SCALMS
AR
LA
MO
IA
MN
WI
NJ
VT
NH
District ofColumbia
AK
HI
RI
DEMD
PhiladelphiaChicago
NYC
San Diego
SanAntonio
Houston
American Samoa Guam N. Mariana Islands Puerto Rico
Partner Contributors: AthenaHealthDXC TechnologyScientific Technologies Corporation (STC) Envision Technology Partners, Inc. HLN Consulting, LLCCerner
Centers for Disease Control and Prevention (CDC)National Institute of Standards and Technology (NIST)Epic Systems CorporationPublic Health Informatics Institute (PHII)
Association of Immunization Managers (AIM) Joint Public Health Informatics Taskforce (JPHIT)National Committee for Quality Assurance (NCQA)Allscripts
Texas Children’s Hospital Battelle Spokane Regional Health District Denver Public Health University of Michigan
AIRA’s educational and training opportunities,
including its Educational Webinars,
Discovery Sessions, Regional Meetings, and the AIRA 2017 National
Meeting reached
1,418 INDIVIDUALS.
Micronesia Marshall Islands Palau Virgin Island